SAN DIEGO – Darlene Marcos Shiley asked a room full of healthcare fundraisers a question: “What in life isn’t work pressing hard for?” As president of the Shiley Foundation in Pauma Valley, Calif., she questioned the wisdom of a funder standing in a room of more than 700 fundraisers at the annual international conference of the Association of Healthcare Philanthropy (AHP).

In a keynote sponsored by Accordant Philanthropy that lasted nearly an hour on Thursday, the discussion centered on what makes a philanthropist tick. Sprinkling in a good dose of self-deprecation, Shiley said the idea of anonymous giving is “baloney.” There is a legacy aspect to naming philanthropy, she explained. In her case it is to ensure her late husband Donald is remembered.

The couple’s fortune is from the development and manufacture of a heart valve. Shiley funds mostly healthcare, education and the arts. There is “total engagement” with those gifts. If giving to a college or university, it is not unusual for her to wander a campus and chat with students. When it comes to public broadcasting, she is known as the “Duchess of Downton” for her gifts to KPBS public television and radio.

Decisions tended to be made at the kitchen table, even with big gifts. She told of the time she and her husband were pitched an idea for funding the start of an eye institute at the University of California San Diego. The physician leading to program asked for $40,000. There were no development people in the room, she said.

The couple asked the doctor about long-range plans for the institute. His was a modest initial plan to start treatment and some research and down the road, hopefully, consolidate operations in a building.

Shiley said that the couple talked about the request and her husband didn’t think the $40,000 was a good idea. The doctor was called and told he wasn’t getting the $40,000. There was silence on the other end of the phone. After a few beats the doctor was told he was getting a seven-figure gift to get the building. The Shiley Eye Institute last year handled 154,000 visits, provided 5,000 surgeries and there were 14,000 free vision exams from a mobile van.

The lesson there is to have a wish list because you never know what will entice a major donor to write a check.

She considers the eye institute the greatest contribution the couple has made to the university, which has received upwards of $40 million from the foundation over the years. The connection to the school started with a modest $25,000 gift.

There must be close stewardship of donations. “Do what you say you are going to do with the money,” she said. Shiley doesn’t want to hear that if things change the money might be used for other purposes. “Oh, no you won’t,” she said of alternate use.

Also, don’t expect funding year after year. “You can’t donate to the same organizations every year. You do have to rotate,” said Shiley.

The idea is to make impact and donors should be pitched that way. Back to the kitchen table, big donors still read the local newspapers. Fundraisers need to get their stories out to the public in traditional methods. Shiley told of reading about a local organization that housed homeless women coming up $15,000 short of goal.

She called and let them know she wanted to cover the shortfall. It was another case of silence on the other end of the phone. Shiley said she drove the check over and the nun running the program was stunned into silence.

“It was a big deal for her,” said Shiley. Impact doesn’t have to start with seven figures.